Hyperglycosylated human chorionic gonadotropin as an early predictor of pregnancy outcomes after in vitro fertilization

Capsule:
Hyperglycosylated human chorionic gonadotropin (hCG) measured as early as 9 days after egg retrieval is superior to traditional hCG and highly predictive of ongoing pregnancies after fresh IVF–embryo transfer.

Authors:
Sandy Chuan, M.D., Michael Homer, M.D., Raj Pandian, Ph.D., Deirdre Conway, M.D., Gabriel Garzo, M.D., Ana Lisa Yeo, C.I.S., Irene Su, M.D., M.S.C.E.

Volume 101, Issue 2, Pages 392-398, February 2014

Abstract:

Objective:
To determine whether serum hyperglycosylated human chorionic gonadotropin (hhCG) measured as early as 9 days after egg retrieval can predict ongoing pregnancies after in vitro fertilization and fresh embryo transfer (IVF-ET).

Design:
Cohort

Setting:
Academic assisted reproduction center.

Patient(s):
Consecutive patients undergoing IVF-ET

Intervention(s):
Serum hhCG and hCG levels measured 9 (D9) and 16 (D16) days after egg retrieval

Main Outcome Measure(s):
Ongoing pregnancy beyond 9 weeks of gestation.

Result(s):
Ongoing pregnancy (62 of 112 participants) was associated with higher D9 levels of hhCG and hCG. However, hhCG was detectable in all D9 OP samples, while hCG was detectable in only 22%. A D9 hhCG level of >110 pg/mL was 96% specific for an ongoing pregnancy, yielding a positive predictive value of 94%. Compared with the D9 hCG levels, hhCG was more sensitive and had a larger area under the curve (0.87 vs. 0.67, respectively). The diagnostic test characteristics were similar between the D16 hhCG and hCG levels.

Conclusion(s):
In patients undergoing assisted reproduction, a test to detect pregnancy early and predict outcomes is highly desirable, and hhCG is detectable in serum 9 days after egg retrieval IVF-ET cycles. In this early assessment, hhCG was superior to traditional hCG and highly predictive of ongoing pregnancies.

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